Lense replacement

[sylvia2012832]

Had lense replacement over 6 months ago, am off 1 diopter in each eye.  Surgeon said he could put a lense in the back of the 1st lense.  Got a 2nd opinion and Dr suggested PRK was a more reasonable option.  Am confused which direction to go.  And can anything be done for the floaters?  Didn't have them in right eye before the surgery.  

[CherylLee76]

Dr. Fazio; Thank you for your help. I understand that having had prior vitrectomies on my left eye as well as cataract surgery can be a much harder case to handle. I also have a bit of scaring in the eye at the top edge according to my last consultation. I did see Dr. Devgan after having had the cataract surgery and I so wish I had gone to see him before taking the step forward into cataract surgery with the other Dr. I had consulted with another Dr. before choosing the Dr. who did the cataract surgery. I chose him because he was highly recommended by a good friend.

Dr. Devgan gave me the list of complications that could happen, which I am sure every Dr. must give to his patients so they know the possible negative outcomes. These complications really scare me as I know they would anyone. I have been trying to adjust to the difference's in the eye's but it does give me anxiety daily. It is a hard choice to make, going forward with an IOL exchange at two months post cataract and prior vitrectomies and hope for the best or possibly try to deal with this for the rest of my life.

If I go forward I would use Dr. Devgan. I wish I had consulted with him prior to my cataract surgery. I hope that anyone reading this will go to more than a couple consultations before going forward with any eye surgery. Go to the best, even talk to prior patients.

Dr. Fazio, why do you consider the list of Doctors you mentioned to be the best? Thank you again.

[dy3000]

Could you recommend someone in the Northwest?
Thanks

[Doreen Fazio, M.D.]

I should also add Samuel Masket in LA.

[Doreen Fazio, M.D.]

This is a difficult situation to analyze without examining you.  An intraocular lens is removed when the power is way off, the lens is decentered, or the patient cannot adapt to glare/haloes (as with a multifocal implant).  You need an expert cataract surgeon, who is also very skilled at intraocular lens exchange.  Do not hesitate to obtain another opinion if in doubt.  You could check the American Academy of Ophthalmology's web site (AAO.org) for a referral.  Some of the very best cataract surgeons in the US are Richard Mackool and Eric Donnenfeld in NY; Robert Cionni in Cincinnati; and Brian Francis, George Rajacich, and Uday Devgan in LA.

[CherylLee76]

I am having trouble adjusting to the IOL implanted on May 28, 2013. I had a two vitrectomies in the left eye, I had horrible floaters and chose that course. The first vitrectomy resulted in a hemorrhage, so a month later the Retinal Dr. performed another vitrectomy to clear the blood. Four months later a cataract formed and on May 28th I had cataract surgery. I had consultations with two different Dr.'s and asked as many questions as I could to see who I felt would perform the surgery and get me to Plano. The mark was overshot my +1.50 and my unoperated eye (right) is +.75. The operated left eye is at +.75 but still feels very off, I have side edge glare on the left side that causes blurriness all the time and I have tried contacts which doesn't help. The glasses I am wearing now are +.50 for the operated eye and +.75 for the right eye, which helps give me more balance even though the eyes are supposedly even at +.75. I have light issues with both eyes, see streaks coming off light sources, strong glare coming off car when the sun hits it, also have blephiritis that the doctor mentioned but didn't explain to me what it was. I had to research that myself.

I have consulted another surgeon who has done very difficult case. He would go forward and explant this IOL and get me to plano and hopefully get rid of the side glare/blurriness. But of course there are complications that could occur.  This has been hard to live with these past seven weeks, what is your opinion?  Thanks for answering my questions and I hope that this helps someone else.

[Doreen Fazio, M.D.]

It would depend on which direction the 1 diopter is off.  If you are slightly myopic (nearsighted), you may want to stay that way since you will be able to work at a computer without glasses, and even read a bit in good light or if the print is larger.  If you are one diopter hyperopic (farsighted), then you will not have clear vision at any distance without correction.  I would avoid a piggyback lens (a second intraocular lens inserted into the eye on top of the first one).  The choices for correction are glasses, contact lenses, PRK, or LASIK.  The first implant could also be removed and exchanged, but this is a risky surgery, especially 6 months out when the original implant lens is firmly fixed in the capsule bag.  As far as the floaters are concerned, if you have had a dilated retinal exam and there are no retinal tears or detachment, you will adapt to them in time and not notice them as much.  They are normal, come with age, and are more common after cataract surgery.  Don't search to find the floaters each day, or your brain won't be able to adapt as readily and filter them out.  However, call your ophthalmologist right away if you have a sudden shower of NEW floaters.